One of the first pathologic changes described in the diabetic patient was an enlarged, fatty liver.1 Since that time, numerous studies have indicated that a fatty liver is present in from 15% to 50% of diabetic patients.2,3 Laboratory evidence of liver dysfunction is present in a significant percentage of diabetic patients.3-5

Fatty metamorphosis of the liver is an integral part of the pathologic picture in the majority of cases of cirrhosis of the liver.6 Many investigators have stated that if a fatty liver from any cause persists, cirrhosis will develop.7 Chaikoff and Connor reported that the production of a fatty liver in the dog by a high-fat diet will ultimately lead to cirrhosis of the liver.8 Pancreatectomized dogs maintained on insulin develop a fatty liver and ultimately show cirrhosis of the liver.9

Despite these facts, a direct relationship between diabetes mellitus and cirrhosis